Norplant

Norplant is a form of birth control released in 1991 by Wyeth Pharmaceuticals, consisting of a set of six small, silicone capsules filled with levonorgestrel, a synthetic progestin used in many birth control pills. In 2002, Norplant was discontinued from production; limited supplies still remained until 2004. A similar product, featuring two rods instead of six, called Jadelle, is approved for US use but is not yet commercially manufactured in the United States.^*

Insertion

Norplant is implanted under the skin in the upper arm of a woman, by creating a small incision and inserting the capsules in a fanlike shape. Insertion of Norplant usually takes 15 minutes and the capsules can sometimes be seen under the skin, although usually they look like small veins. They can also be felt under the skin. Once inserted, the contraceptive works within 24 hours and lasts up to five years.

Function and effectiveness

Norplant works by preventing ovulation, which means that no eggs are released for fertilization; by thickening the mucus of the uterus, which prevents sperm from entering; and by thinning the lining of the uterus, which makes implementation of an egg less likely. A small amount of the hormone is released through the capsules continuously, more during the first year and a half, but then at a level similar to most contraceptive pills afterward. According to studies completed, Norplant has been shown to be 99% – 99.95% effective at preventing pregnancy, and is one of the most reliable, though not the most available, forms of birth control around. It is important that people understand Norplant, however, does not protect against sexually transmitted diseases.

Contraindications

Norplant should not be used in women with liver disease, breast cancer, or blood clots. Women who believe they may already be pregnant or those with vaginal bleeding should first see a physician. However, since Norplant does not contain estrogen like some birth control pills, older women, women who smoke, and women with high blood pressure are not restricted from using the system.

Side effects

After three months of using Norplant, women will need to schedule a follow-up appointment to monitor blood pressure and discuss any concerns. Side effects may include irregular menstrual periods for the first approximately three months, including periods lasting longer than normal, bleeding or spotting between periods, or going with no period for the mentioned period of time. These changes are not serious. Less common side effects include weight gain or loss, headache, depression, acne, or excessive hair growth. Sometimes, mild pain or itching at the site of the implant will occur. Ovarian cysts may also occur, but usually do not require treatment.

Removal

Norplant can be removed with only minor inconvenience at any time by creating a second incision and withdrawing the capsules. Norplant is normally removed when the five year period is over and reinsertion of a new set is preferred, or if:

Pregnancy is desired
Differing birth control is preferred
Complications arise

Pulled from the market

Norplant ceased distribution in July 2002 because of limitations in component supplies and serious side effects.^* Women who currently have the implants will need to find a new method of contraception once they expire, such as an intrauterine device or Depo Provera injections.